La equidad sanitaria se está convirtiendo en una prioridad en Carolina del Norte a medida que Medicaid experimenta cambios. Las personas en todo el estado están experimentando actualizaciones que significan que algunas personas transicionarán a la atención médica mientras que otras pueden perder su cobertura. Muchas personas también serán elegibles para Medicaid por primera vez. Todas estas actualizaciones son cosas que, según los defensores de salud, pueden empeorar las disparidades ya existentes.

Para abordar esto, Madison Allen senior de Kate B. Reynolds Charitable Trust explica que están colaborando con organizaciones locales para amplificar la retroalimentación y abordar los problemas.

"Algunos de los problemas que nos han comunicado los beneficiarios son las dificultades para inscribirse o darse de baja en los planes, los desafíos de los proveedores en la red, problemas de acceso al transporte y procesos de apelación confusos," explica Allen.

Además, afirma que los beneficiarios han encontrado casos en los que no se ha acomodado a personas con discapacidades. Allen subraya que los grupos e investigadores que apoyan están trabajando activamente como intermediarios entre la comunidad y los programas para garantizar que las personas reciban los beneficios que merecen.

Alrededor del 47% de los ciudadanos no estadounidenses carecen de seguro médico.
Hamutal Bernstein, del Urban Institute, explica que estos retos pueden ser aún más difíciles para las familias migrantes.

Un informe reciente titulado "Apoyando a las familias migrantes de Carolina del Norte" revela que existe un número creciente de residentes de habla hispana, swahili y hmong en el estado.

Bernstein explica que muchas de estas familias se enfrentan a barreras lingüísticas, aunado a problemas de migración y discriminación. Bernstein dice que, en algunos casos, se encuentran con largos procesos de inscripción y luchan por recibir ayuda con la documentación, lo que impide a algunos miembros de la familia que reúnen los requisitos a que accedan a programas esenciales de la red de seguridad.

"Así que hay familias en las que hay ciudadanos estadounidenses," explica Bernstein. "Hay ciudadanos nacidos en los Estados Unidos, hay ciudadanos nacionalizados, a veces hay miembros indocumentados y puede haber miembros de la familia elegibles para un programa y otros miembros de la familia que no son elegibles en lo absoluto, así que las familias tienen que resolver todo eso."

Según el informe, algunas agencias no están seguras de las necesidades lingüísticas de sus respectivos condados. Para solucionarlo, se ha creado una herramienta de datos que permite conocer las necesidades lingüísticas.

El informe también recomienda soluciones como contratar personal que represente a las comunidades migrantes, mejorar la accesibilidad al idioma más allá del español y utilizar modos de comunicación específicos para los distintos grupos de edad.




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After more than 50 years of use, some Michigan lawmakers say naloxone may not be the best choice in an overdose situation.

Naloxone is sometimes called the "Lazarus drug" because of its powerful ability to seemingly resurrect people after a drug overdose.

Sen. Kevin Hertel, D-St. Clair Shores, and some of his colleagues have introduced a bill which would open the door for what they say are more costly, but more powerful, antidotes.

"Given the prevalence of fentanyl in our communities, and how much stronger some of these drugs that we're now seeing are, we believe -- and in talking with others -- that there should be other tools to respond to an overdose," Hertel explained. "To make sure we're doing everything we can to save somebody's life."

Not everyone is on board with the proposed legislation, Senate Bill 542. Opponents argued the more expensive naloxone alternatives are not necessary, and using them would only increase profits for the pharmaceutical industry.

Jonathan Stoltman, director of the Opioid Policy Institute in Grand Rapids, said while the naloxone alternatives do help in overdose situations, they can also cause nasty side effects.

"The newer approaches, they put people into more severe withdrawal," Stoltman pointed out. "That's a pretty profound negative side effect. The one approach is very inexpensive and works great; the other approach is far more expensive and has this strong negative side effect."

Sponsors of the bill say they're hoping to give Michigan residents a chance to chime in on the issue in a public hearing sometime in June. Michigan saw more than 3,000 opioid overdose deaths in 2021.


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New Mexico saw record enrollment numbers for the Affordable Care Act this year and is now setting its sights on lowering out-of-pocket costs - those not reimbursed by insurance. More than 56,000 New Mexicans are enrolled in a medical health insurance plan on the state exchange - an increase of 12,000 people overall.

Colin Baillio, deputy superintendent with the state's Office of Insurance, said the state has boosted its outreach and made efforts to improve the overall consumer experience.

"We saw a 40% year-over-year increase, and New Mexico saw the biggest percentage increase during the open-enrollment period among all of the state-based marketplaces," he explained

Part of the enrollment increase is due to what's called the "unwinding" - a federal directive that required all states to redetermine Medicaid eligibility following a three-year pause on checks during the COVID pandemic. He said by using expanded tools made available by the federal and state government, 8% of New Mexico's population is now uninsured - down from 23% in 2010.

Following approval by lawmakers in the 2024 legislative session, the New Mexico governor signed seven health care-related bills into law - one of which requires annual reporting of prescription drug pricing. Baililo said the Affordable Care Act built the foundation that has allowed the state to pursue additional affordability initiatives.

"I'm really glad to see that there's so much interest in the next step of health reform, really leaning into these out-of-pocket cost issues and making it easier for people to afford to stay covered and see their doctors," he continued.

Two years ago, the state also passed a one-of-a-kind law that did away with behavioral health co-pays for people in certain insurance plans.

New York's medical aid-in-dying bill is gaining further support. The Medical Society of the State of New York is supporting the bill. New York's bill allows terminally ill people with only six months to live to use this option, with safeguards requiring two physicians' approval.

The bill's Assembly sponsor Amy Paulin, D-Westchester, said despite the growing support, other hurdles lie ahead.

"Now we have what I believe, if it came to the floor, a majority. There's still a hesitation on the part of leadership. You know, we need members to assure leadership that they no longer have reservations," she said.

Other newly resolved concerns center on making sure insurance companies and doctors who don't support this aren't held liable. She's optimistic the bill will pass after nine years in the Legislature. New York would be the 11th state along with Washington, D.C. to have medical aid in dying legislation.

Corinne Carey, senior New York campaign director with Compassion and Choices finds the pandemic drew a vivid picture of a person's end-of-life experience. There were images of people dying on ventilators, apart from loved ones, and unable to communicate. She said people began thinking about a "good death."

"And, what is a good death is being surrounded by loved ones, having some measure of control, experiencing the touch of your loved ones, and being the one in the driver's seat," she explained.

Now people have different options for end-of-life care, each of which presents various challenges. Polls show medical aid in dying has garnered considerable support since being introduced in 2015. A 2022 Compassion and Choices poll finds 57% of nurses support medical aid in dying professionally, although fewer support it personally.